APPLICATION FORM

Completely fill-out the fields below. Kindly write in PRINT. Do not leave anything blank.
Please write “Not Applicable or N/A” if the information being asked does not apply to you. Thank
You!
PERSONAL DATA
First Name Middle Name Last Name Suffix
REZIA LECAH GERVACIO LOMONGO N/A

Applying for the Position of: M.I.S SPECIALIST Citizenship: FILIPINO Gender: ( ) Male (✓) Female
Mobile Phone Number: 09678408281 Email Address: Date of Birth (MM/DD/YYYY) Civil Status:
(✓) Single ( ) Married
Home Phone Number: [email protected] APRIL 8, 1994 ( ) Separated ( ) Widow/er
N/A ( ) Annulled / Divorced
SSS No.: 08-3138465-2 Pag-ibig No.: 121314683549 Phil Health No.: 15-025650031-2
With Work Experience: (✓) Yes ( ) No SOURCE OF APPLICATION: REFERRAL FROM LSERV
Present Address:
ZONE 4, MOOG, LAGUINDINGAN, MISAMIS ORIENTAL

Permanent Address:
ZONE 4, MOOG, LAGUINDINGAN, MISAMIS ORIENTAL

EDUCATIONAL BACKGROUND
Please check highest educational attainment:
( ) Masteral / Doctorate Degree ( ) Associate / 2-Year Degree ( ) High School Graduate
(✓) Bachelor’s Degree ( ) Certificate Course ( ) Some College (Undergraduate)
Please specify -Year Level: ( ) 1st Year ( ) 2nd Year ( ) 3rd Year ( ) 4th Year

School Name: BUKIDNON STATE UNIVERSITY School Address / Branch: BUKSU ALUBIJID BRANCH

Degree Conferred: BACHELOR OF ARTS MAJOR IN ENGLISH LANGUAGE Major (If Applicable): ENGLISH

Dates (mm/yy): From: JUNE 2013 To: MARCH 2017 Year Graduated: 2017

EMPLOYMENT HISTORY - Please indicate your employment for the last seven (7) years
Date of Employment
Company Name & Address Position Reason for Leaving Contact No.
Start Date End Date
ADMIN SUPPORT FEBRUARY APRIL 25, LAGUINDINGAN 288432077
STAFF 07, 2023 2025 AIRPORT
1. CIVIL AVIATION AUTHORITY OF THE PHILIPPINES/ LSERV PRIVATIZATION
CORPORATION

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 Date of Employment
Company Name & Address Position Reason for Leaving Contact No.
Start Date End Date

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PROFESSIONAL REFERENCES : Kindly include contact numbers of previous colleagues, supervisor, HR staff, etc. (mobile, home
phone and/or work phone numbers)
Name Position Company Name / Address Contact Nos.
FDRCCU CAAP — LAGUINDINGAN AIRPORT
SUPERVISOR
1. JAMES M. CAIÑA

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NEIGHBOR REFERENCES : Kindly include contact numbers (mobile, home phone and/or work phone numbers)
Name Position Company Name / Address Contact Nos.
1. GERLINDA G. BURAY PUNONG ZONE 4 BARANGAY HALL N/A
BARANGAY
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LOMONGO REZIA LECAH G.

SIGNATURE OVER PRINTED NAME / DATE

I hereby know and understand that as part of the application process, I shall be subjected to a BACKGROUND CHECK
commissioned by . Hence, I hereby authorize CBRE and or its authorized representative to confirm and
verify information/s stated above prior to employment, including matters of conduct, behavior, ability, reputation, education,
family, and as well as my criminal, financial and credit standing. I also authorize and request each person and firm referred in my
Application Form to give such information
 NOTICE OF CONSENT AND APPROVAL FOR
EMPLOYMENT VERIFICATION

I authorize C B R E and or its authorized representative to verify and check in my

behalf, any and all information pertinent to my employment background.

EMPLOYER INFORMATION:

Company Name / Address: Contact Details:

1. LSERV CORPORATION 288432077

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I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without
compulsion and intimidation from the company.

WITH MY FULL CONSENT AND

AUTHORITY,

LOMONGO REZIA LECAH G.

SIGNATURE OVER PRINTED NAME
 NOTICE OF CONSENT AND APPROVAL

This is to give my consent and approval to allow CBRE and or its authorized representative to
verify the validity and truthfulness of all information stated in my application form.
I likewise authorize and or it’s authorized representative to verify and check in my behalf, with the Registrar of
BUKIDNON STATE UNIVERSITY ALUBIJID EXTENSION located at
(Indicate the name of the College / University)
ALUBIJID, MISAMIS ORIENTAL where I took BACHELO OF ARTS MAJOR IN ENGLISH LANGUAGE
(College/University Address) (Degree Conferred / Course)
from year 2 0 1 3 to 2 0 1 7 any and all information pertinent to my educational background
and information.

That I am executing this NOTICE OF CONSENT AND APPROVAL, willingly and voluntarily, without compulsion and
intimidation from the company.

WITH MY FULL CONSENT AND AUTHORITY

LOMONGO REZIA LECAH G.

SIGNATURE OVER PRINTED NAME